Inflammatory markers predict survival in patients with postoperative urothelial carcinoma receiving tislelizumab (PD-1 inhibitor) adjuvant therapy

• Published in: BMC cancer Vol. 24; no. 1; p. 196
• Main Authors: Yang, Meng, Zhang, Jingwen, Wei, Dongqun, Yu, Tianyi, Chen, Zeyu, Liu, Xin, Zhu, Haitao
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.02.2024; BioMed Central; BMC
• Subjects: Adjuvant therapy; Adjuvant treatment; Antibodies, Monoclonal, Humanized; Antigens; Apoptosis; B cells; Bladder cancer; Cancer; Cancer therapies; Carcinoma; Carcinoma, Transitional Cell - pathology; Care and treatment; Cell death; Chemotherapy; Development and progression; Diagnosis; Drug therapy; Health aspects; Humans; Immune Checkpoint Inhibitors; Immune system; Immunotherapy; Inflammation; Inflammatory markers; Ipilimumab; Leukocytes (neutrophilic); Ligands; Lymphocytes; Lymphocytes - pathology; Medical colleges; Medical prognosis; Medical research; Medicine, Experimental; Monocytes; Multivariate analysis; Neutrophils - pathology; Patient outcomes; Patients; PD-1 protein; Platelet Count; Prognosis; Regression analysis; Retrospective Studies; Risk factors; Survival; Tislelizumab; Tumors; Urinary Bladder Neoplasms - pathology; Urinary tract cancer; Urological surgery; Urothelial carcinoma; China; Tislelizumab; Inflammatory markers; Urothelial carcinoma; Survival; Immunotherapy
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-11969-5

In the management of urothelial carcinoma, patient selection for immunotherapy, particularly with immune checkpoint inhibitors such as PD-1 (programmed cell death protein 1), is important for treatment efficacy. Inflammatory markers are useful for predicting treatment outcomes and immune-related adverse events (irAEs). This study aims to retrospectively explore the associations between inflammatory markers and outcomes in patients with postoperative urothelial carcinoma undergoing tislelizumab (PD-1 inhibitor) adjuvant therapy. A retrospective analysis was conducted on 133 patients with postoperative urothelial carcinoma who received tislelizumab adjuvant therapy at the Affiliated Hospital of Xuzhou Medical University from April 2020 to August 2023. The prognostic effects of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) on disease-free survival (DFS) and overall survival (OS) were assessed using Cox regression models. The correlation between inflammatory markers and the onset of irAEs was analyzed using logistic regression models. NLR < 5 and MLR < 0.31 were significantly associated with better outcomes compared to NLR >5 and MLR >0.31, respectively. Multivariate analysis revealed that an NLR < 5 was independently associated with better DFS and OS. However, there was no significant effect on the DFS and OS between PLR < 135 and PLR >135. Patients who experienced irAEs had longer DFS and OS. Multivariate analysis demonstrated that irAEs were an independent prognostic risk factor for DFS and OS. There was no significant difference in the occurrence of irAEs among different NLR, PLR, and MLR groups. In patients with postoperative urothelial carcinoma receiving tislelizumab adjuvant therapy, the assessment of NLR and MLR before treatment may serve as valuable predictive markers of clinical outcome.